Time bomb in the head, brain aneurysm, 30% dead in rupture...What's the cure?
Oct 12, 2025
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More than 80-90% of brain aneurysms occur in the branch where blood vessels in the brain are split, and the branch is more likely to weaken the blood vessel wall than other areas because pressure is concentrated on the blood vessel wall as blood flows are split. Brain aneurysm does not require immediate treatment, but caution is needed because at some point, brain aneurysm cannot overcome blood pressure and ruptures can cause cerebral hemorrhage (substituted hemorrhage).
◇Family history increases the risk of development four times higher
The size of the brain aneurysm varies from as small as 2 mm to as large as 50 mm or more, and is found between 40s and 70s.
The cause of cerebral aneurysm is not clearly identified, but structural vulnerability of vascular walls, hypertension, smoking, genetic factors (family history), and chronic hemodynamic burden causing vascular wall damage are known to be major risk factors. It may occur when the blood vessel wall is damaged by inflammation or trauma in the blood vessel, and may be accompanied by cerebrovascular diseases such as cerebral arteriovenous malformations or moyamoya disease. Smoking and high blood pressure are known to increase the risk of developing brain aneurysms, and it is reported that having brain aneurysms in the family is about four times higher than the general public.
Most brain aneurysms have no specific symptoms until they rupture, so they are often accidentally detected at medical examinations.
When the size of the brain aneurysm is large or compresses the surrounding nerve tissue at a specific location, abnormal neurological symptoms such as visual field abnormalities, vision loss, sensory loss, dizziness, and headache may appear.
Professor Cho Hyun-joon of Neurosurgery at Korea University Guro Hospital said, `When aneurysm ruptures, you feel a severe headache that has never been experienced before. It is accompanied by nausea, vomiting, and stiff back neck, and in severe cases, neurological symptoms such as paralysis, loss of consciousness, and seizures can occur as pressure in the skull rises. Approximately 30% of patients with cerebral aneurysm rupture die, and in half of the survivors, permanent nerve damage can occur, so if you develop any suspicious symptoms, you should visit the emergency room promptly"Emphasize.
◇ Attention to treatments that compensate for existing shortcomings
Treatment methods include clip ligation to open the head and clip the swollen blood vessel area, and coil embolization to prevent rupture by inserting a thin coil of less than 1 mm into the brain aneurysm through the blood vessel to block blood flow to the mother artery. Which treatment method to apply is decided by comprehensively considering the patient's condition, the location and size of the aneurysm, and the possibility of recurrence. Clip ligation is performed when there is a high probability of recurrence or complications, when the patient is young, and when there is a brain aneurysm in the epidermis of the brain, and although the recurrence rate is low, there is a burden to open the brain and operate. On the other hand, coil embolization is often performed on elderly patients because of its lower burden and faster recovery than clip ligation, but it has the disadvantage of relatively high recurrence rate.
Recently, advanced technologies that compensate for the shortcomings of existing methods in testing and treatment methods have been developed and applied. In particular, the method of using the radial artery (wrist) rather than the femoral artery in the cerebrovascular angiography that is applied to the diagnosis and treatment of cerebral aneurysm is drawing attention.
Professor Cho Hyun-jun said, `We have previously approached cerebrovascular angiography through the femoral artery, but in our hospital, we approach it through the radial artery.'"If approached through the radial artery, the procedure time is similar compared to the approach through the femoral artery, but it has the advantage of being quick to recover." The femoral artery requires hemostasis for more than two to three hours while the patient lies down after the procedure, but only a hemostatic band can be attached to the wrist, so it can be active immediately after the procedure. In addition, since the radial artery is much thinner than the femoral artery, it is reported that the possibility of hematoma occurring around the treatment site after the procedure is significantly lower."
Various surgeries and procedures optimized for high-level lesions are also actively applied depending on the type and shape of brain aneurysm. Instead of opening the head and proceeding with clip ligation, it is also performed by minimizing the incision by making a small hole of less than 3cm in the eyebrows or temples. In addition, for the treatment of brain aneurysms that are difficult to treat with coil embolization or macrobrain aneurysms larger than 25mm, a 'blood transformation stent procedure' is applied by inserting a stent, not a coil, into the brain aneurysm to change the direction of blood flow.
Furthermore, if the brain aneurysm occurs in areas where blood vessels overlap and the difficulty of the procedure is high, 'blood flow conversion stent procedure through balloons' is performed, and the difficulty of the procedure is high due to the simultaneous balloon and stent procedure, but more sophisticated procedures are possible and safety is high. The branched brain aneurysm that occurs at the point where the blood vessels diverge is wide, so coil embolization alone is not enough. In this case, a device called 'Woven EndoBridge (WEB)', which is a tightly woven metal net, is filled into the brain aneurysm.
Professor Cho "Common coil embolization is used with stents when the aneurysm's neck is wide and there is a risk that the coil will pop out of the blood vessels, and WEB can complete the procedure with just one, which shortens the procedure time and can stably block the aneurysm. In addition, the use of a stent can reduce the duration of taking antiplatelet drugs, and the risk of bleeding complications is also low, he added. As such, a variety of new treatments have been developed to compensate for the shortcomings of existing ligation and coil embolization, while enhancing the therapeutic effect, enabling customized treatment.
◇ Prevent rebleeding and recurrence through follow-up management even after treatment
Systematic management and lifestyle correction are very important because brain aneurysm poses a risk of rebleeding, recurrence, or complications even after treatment.
Professor Cho Hyun-jun said "If you have a coil embolization or stent, you should consistently take antiplatelet drugs to prevent thrombus formation, and you should periodically follow up on recurrence or complications. Smoking is known to increase the risk of recurrence and growth of aneurysms, so you should quit smoking and refrain from drinking alcohol that sharply raises your blood pressure. In addition, high blood pressure can increase the risk of rebleeding, so it is recommended to thoroughly control it and manage hyperlipidemia, diabetes, and obesity to lower the risk of vascular disease.'
There is no way to prevent the onset of cerebral aneurysm itself because the obvious cause of the aneurysm has not been identified.
Professor Cho said, `Although it is not possible to prevent the onset of cerebral aneurysm itself, early detection can prevent cerebral hemorrhage before bursting, so if you have a cerebral aneurysm in your family, or if you are a smoker and belong to a high-risk group with high blood pressure, you should get a medical examination.'
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This article was translated by Naver AI translator.
